Purpose: :
To investigate the long term ophthalmic outcomes of AfricanAmericans with severe retinopathy of prematurity (ROP) comparedto other races.

Methods: :
A restrospective chart review was conducted for all infantsat the University of Mississippi Medical Center requiring laserfor severe ROP from January 2001 - December 2009. Gestationalage, sex, race, birth weight, length of postoperative follow-up,and the zone and stage of ROP at the time of laser applicationwere analyzed. Additional data was evaluated for the presenceof the following postoperative outcomes: refractive error, pathologicmyopia, strabismus, amblyopia, nystagmus, optic atrophy, significantCNS disease, cataract, glaucoma, macular drag or fold, and finalstructural outcome of the treated retina. Results were groupedfor analysis and compared outcomes of African Americans (AA)to all other races (O).

Results: :
Of the 161 eyes meeting inclusion criteria 64.6% were AfricanAmerican and 35.4% represented other races. Each group was similarin its gender distribution and zone involvement at the timeof laser treatment. African American infants with severe ROPwere found to have significantly lower gestational age and birthweight than the other races (24.52 weeks AA, 25.74 weeks O,p = 0.00002; 689 grams AA, 808 grams O, p = 0.0004.) AfricanAmerican infants were also found to have a more advanced stageof ROP at the time of laser treatment (2.94 AA, 2.72 O, p =0.0003.) Additionally the African American group was found tohave more than twice the rate of strabismus when compared toother races, a significant difference (42% AA, 19% O, p value= 0.003.) No statistical difference was observed between thetwo groups in relation to the presence of refractive error,pathologic myopia, amblyopia, CNS disease, nystagmus, opticnerve atrophy, cataracts, glaucoma, macular drag/fold, or favorablestructural outcome. Favorable structural outcomes were >90%for both groups.

Conclusions: :
While African American infants with severe ROP demonstratedlower gestational age and birth weight as well as more advancedstaging at time of laser treatment than infants of other races,ophthalmic outcomes were very similar between the two groupsin all areas studied except for strabismus, which was twiceas likely to develop in African Americans. Despite the knownreduced relative risk of African Americans progressing to severeROP compared to other races, our study demonstrated that forAfrican Americans who do develop severe ROP there does not appearto be a similar protective advantage with respect to long-termophthalmic outcomes.